Charting the road forward in psychiatric neurosurgery: Proceedings of the 2016 American Society for Stereotactic and Functional Neurosurgery workshop on neuromodulation for psychiatric disorders

Ausaf A. Bari, Charles B. Mikell, Aviva Abosch, Sharona Ben-Haim, Robert J. Buchanan, Allen W. Burton, Stephen Carcieri, G. Rees Cosgrove, Pierre Francois D'Haese, Zafiris Jeffrey Daskalakis, Emad N. Eskandar, Jason L. Gerrard, Wayne K. Goodman, Benjamin David Greenberg, Robert E. Gross, Clement Hamani, Zelma H.T. Kiss, Peter Konrad, Brian H. Kopell, Lothar KrinkeJean Philippe Langevin, Andres M. Lozano, Donald Malone, Helen S. Mayberg, Jonathan P. Miller, Parag G. Patil, Delea Peichel, Erika A. Petersen, Ali R. Rezai, R. Mark Richardson, Patricio Riva-Posse, Tejas Sankar, Jason M. Schwalb, Helen Blair Simpson, Konstantin Slavin, Paul H. Stypulkowski, Tor Tosteson, Peter Warnke, Jon T. Willie, Kareem A. Zaghloul, Joseph S. Neimat, Nader Pouratian, Sameer A. Sheth

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Objective Refractory psychiatric disease is a major cause of morbidity and mortality worldwide, and there is a great need for new treatments. In the last decade, investigators piloted novel deep brain stimulation (DBS)-based therapies for depression and obsessive-compulsive disorder (OCD). Results from recent pivotal trials of these therapies, however, did not demonstrate the degree of efficacy expected from previous smaller trials. To discuss next steps, neurosurgeons, neurologists, psychiatrists and representatives from industry convened a workshop sponsored by the American Society for Stereotactic and Functional Neurosurgery in Chicago, Illinois, in June of 2016. Design Here we summarise the proceedings of the workshop. Participants discussed a number of issues of importance to the community. First, we discussed how to interpret results from the recent pivotal trials of DBS for OCD and depression. We then reviewed what can be learnt from lesions and closed-loop neurostimulation. Subsequently, representatives from the National Institutes of Health, the Food and Drug Administration and industry discussed their views on neuromodulation for psychiatric disorders. In particular, these third parties discussed their criteria for moving forward with new trials. Finally, we discussed the best way of confirming safety and efficacy of these therapies, including registries and clinical trial design. We close by discussing next steps in the journey to new neuromodulatory therapies for these devastating illnesses. Conclusion Interest and motivation remain strong for deep brain stimulation for psychiatric disease. Progress will require coordinated efforts by all stakeholders.

Original languageEnglish (US)
Pages (from-to)886-896
Number of pages11
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume89
Issue number8
DOIs
StatePublished - Aug 1 2018

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Keywords

  • Depression
  • Electrical stimulation
  • Psychiatry
  • Stereotaxic surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Bari, A. A., Mikell, C. B., Abosch, A., Ben-Haim, S., Buchanan, R. J., Burton, A. W., Carcieri, S., Cosgrove, G. R., D'Haese, P. F., Daskalakis, Z. J., Eskandar, E. N., Gerrard, J. L., Goodman, W. K., Greenberg, B. D., Gross, R. E., Hamani, C., Kiss, Z. H. T., Konrad, P., Kopell, B. H., ... Sheth, S. A. (2018). Charting the road forward in psychiatric neurosurgery: Proceedings of the 2016 American Society for Stereotactic and Functional Neurosurgery workshop on neuromodulation for psychiatric disorders. Journal of Neurology, Neurosurgery and Psychiatry, 89(8), 886-896. https://doi.org/10.1136/jnnp-2017-317082